tbuckley/cabot-search huggingface dataset:
Risk of hematological malignancies from CT radiation exposure in children, adolescents and young adults
Authors: Magda Bosch de Basea Gomez, Isabelle Thierry-Chef, Richard Harbron, Michael Hauptmann, Graham Byrnes, Maria-Odile Bernier, Lucian Le Cornet, Jérémie Dabin, Gilles Ferro, Tore S. Istad, Andreas Jahnen, Choonsik Lee, Carlo Maccia, Françoise Malchair, Hilde Olerud, Steven L. Simon, Jordi Figuerola, Anna Peiro, Hilde Engels, Christoffer Johansen, Maria Blettner, Magnus Kaijser, Kristina Kjaerheim, Amy Berrington de Gonzalez, Neige Journy, Johanna M. Meulepas, Monika Moissonnier, Arvid Nordenskjold, Roman Pokora, Cecile Ronckers, Joachim Schüz, Ausrele Kesminiene, Elisabeth Cardis
Journal: Nature Medicine (2023)

Over one million European children undergo computed tomography (CT) scans annually. Although moderate- to high-dose ionizing radiation exposure is an established risk factor for hematological malignancies, risks at CT examination dose levels remain uncertain. Here we followed up a multinational cohort (EPI-CT) of 948,174 individuals who underwent CT examinations before age 22 years in nine European countries. Radiation doses to the active bone marrow were estimated on the basis of body part scanned, patient characteristics, time period and inferred CT technical parameters. We found an association between cumulative dose and risk of all hematological malignancies, with an excess relative risk of 1.96 (95% confidence interval 1.10 to 3.12) per 100 mGy (790 cases). Similar estimates were obtained for lymphoid and myeloid malignancies. Results suggest that for every 10,000 children examined today (mean dose 8 mGy), 1-2 persons are expected to develop a hematological malignancy attributable to radiation exposure in the subsequent 12 years. Our results strengthen the body of evidence of increased cancer risk at low radiation doses and highlight the need for continued justification of pediatric CT examinations and optimization of doses.
Hypomorphic variants of SEL1L-HRD1 ER-associated degradation are associated with neurodevelopmental disorders
Authors: Huilun H Wang, Liangguang L Lin, Zexin J Li, Xiaoqiong Wei, Omar Askander, Gerarda Cappuccio, Mais O Hashem, Laurence Hubert, Arnold Munnich, Mashael Alqahtani, Qi Pang, Margit Burmeister, You Lu, Karine Poirier, Claude Besmond, Shengyi Sun, Nicola Brunetti-Pierri, Fowzan S Alkuraya, Ling Qi
Journal: Journal of Clinical Investigation (2023)

Recent studies using cell type-specific knockout mouse models have improved our understanding of the pathophysiological relevance of suppressor of lin-12-like-HMG-CoA reductase degradation 1 (SEL1L-HRD1) endoplasmic reticulum-associated (ER-associated) degradation (ERAD); however, its importance in humans remains unclear, as no disease variant has been identified. Here, we report the identification of 3 biallelic missense variants of SEL1L and HRD1 (or SYVN1) in 6 children from 3 independent families presenting with developmental delay, intellectual disability, microcephaly, facial dysmorphisms, hypotonia, and/or ataxia. These SEL1L (p.Gly585Asp, p.Met528Arg) and HRD1 (p.Pro398Leu) variants were hypomorphic and impaired ERAD function at distinct steps of ERAD, including substrate recruitment (SEL1L p.Gly585Asp), SEL1L-HRD1 complex formation (SEL1L p.Met528Arg), and HRD1 activity (HRD1 p.Pro398Leu). Our study not only provides insights into the structure-function relationship of SEL1L-HRD1 ERAD, but also establishes the importance of SEL1L-HRD1 ERAD in humans.
Frailty, Home Time, and Health Care Costs in Older Adults With Atrial Fibrillation Receiving Oral Anticoagulants
Authors: Kueiyu Joshua Lin, Daniel E. Singer, Darae Ko, Robert Glynn, Mehdi Najafzadeh, Su Been Lee, Lily Gui Bessette, Alexander Cervone, Elyse DiCesare, Dae Hyun Kim
Journal: JAMA Network Open (2023)

Importance There are no data on patient-centered outcomes and health care costs by frailty in patients with atrial fibrillation (AF) taking oral anticoagulants (OACs). Objective To compare home time, clinical events, and health care costs associated with OACs by frailty levels in older adults with AF. Design, Setting, and Participants This community-based cohort study assessed Medicare fee-for-service beneficiaries 65 years or older with AF from January 1, 2013, to December 31, 2019. Data analysis was performed from January to December 2022. Exposures Apixaban, rivaroxaban, and warfarin use were measured from prescription claims. Frailty was measured using a validated claims-based frailty index. Main outcomes and measures Outcome measures were (1) home time (days alive out of the hospital and skilled nursing facility) loss greater than 14 days; (2) a composite end point of ischemic stroke, systemic embolism, major bleeding, or death; and (3) total cost per member per year after propensity score overlap weighting. Results The weighted population comprised 136 551 beneficiaries, including 45 950 taking apixaban (mean [SD] age, 77.6 [7.3] years; 51.3% female), 45 320 taking rivaroxaban (mean [SD] age, 77.6 [7.3] years; 51.9% female), and 45 281 taking warfarin (mean [SD] age, 77.6 [7.3] years; 52.0% female). Compared with apixaban, rivaroxaban was associated with increased risk of home time lost greater than 14 days (risk difference per 100 persons, 1.8 [95% CI, 1.5-2.1]), composite end point (rate difference per 1000 person-years, 21.3 [95% CI, 16.4-26.2]), and total cost (mean difference, $890 [95% CI, $652-$1127]), with greater differences among the beneficiaries with frailty. Use of warfarin relative to apixaban was associated with increased home time lost (risk difference per 100 persons, 3.2 [95% CI, 2.9-3.5]) and composite end point (rate difference per 1000 person-years, 29.4 [95% CI, 24.5-34.3]), with greater differences among the beneficiaries with frailty. Compared with apixaban, warfarin was associated with lower total cost (mean difference, −$1166 [95% CI, −$1396 to −$937]) but higher cost when excluding OAC cost (mean difference, $1409 [95% CI, $1177 to $1642]) regardless of frailty levels. Conclusions and Relevance In older adults with AF, apixaban was associated with increased home time and lower rates of clinical events than rivaroxaban and warfarin, especially for those with frailty. Apixaban was associated with lower total cost compared with rivaroxaban but higher cost compared with warfarin due to higher OAC cost. These findings suggest that apixaban may be preferred for older adults with AF, particularly those with frailty.
Global Stage Distribution of Breast Cancer at Diagnosis
Authors: Javier David Benitez Fuentes, Eileen Morgan, Alicia de Luna Aguilar, Allini Mafra, Richa Shah, Francesco Giusti, Jérôme Vignat, Ariana Znaor, Carina Musetti, Cheng-Har Yip, Liesbet Van Eycken, Elima Jedy-Agba, Marion Piñeros, Isabelle Soerjomataram
Journal: JAMA Oncology (2023)

Importance Stage at diagnosis is a key prognostic factor for cancer survival. Objective To assess the global distribution of breast cancer stage by country, age group, calendar period, and socioeconomic status using population-based data. Data Sources A systematic search of MEDLINE and Web of Science databases and registry websites and gray literature was conducted for articles or reports published between January 1, 2000, and June 20, 2022. Study Selection Reports on stage at diagnosis for individuals with primary breast cancer (C50) from a population-based cancer registry were included. Data Extraction and Synthesis Study characteristics and results of eligible studies were independently extracted by 2 pairs of reviewers (J.D.B.F., A.D.A., A.M., R.S., and F.G.). Stage-specific proportions were extracted and cancer registry data quality and risk of bias were assessed. National pooled estimates were calculated for subnational or annual data sets using a hierarchical rule of the most relevant and high-quality data to avoid duplicates. Main Outcomes and Measures The proportion of women with breast cancer by (TNM Classification of Malignant Tumors or the Surveillance, Epidemiology, and End Results Program [SEER]) stage group. Results Data were available for 2.4 million women with breast cancer from 81 countries. Globally, the proportion of cases with distant metastatic breast cancer at diagnosis was high in sub-Saharan Africa, ranging from 5.6% to 30.6% and low in North America ranging from 0.0% to 6.0%. The proportion of patients diagnosed with distant metastatic disease decreased over the past 2 decades from around 3.8% to 35.8% (early 2000s) to 3.2% to 11.6% (2015 onwards), yet stabilization or slight increases were also observed. Older age and lower socioeconomic status had the largest proportion of cases diagnosed with distant metastatic stage ranging from 2.0% to 15.7% among the younger to 4.1% to 33.9% among the oldest age group, and from 1.7% to 8.3% in the least disadvantaged groups to 2.8% to 11.4% in the most disadvantaged groups. Conclusions and Relevance Effective policy and interventions have resulted in decreased proportions of women diagnosed with metastatic breast cancer at diagnosis in high-income countries, yet inequality persists, which needs to be addressed through increased awareness of breast cancer symptoms and early detection. Improving global coverage and quality of population-based cancer registries, including the collection of standardized stage data, is key to monitoring progress.
Gut microbiota and tumor-associated macrophages: potential in tumor diagnosis and treatment
Authors: Dongqin Zhou, Yongsheng Li
Journal: Gut Microbes (2023)

Avoiding immune destruction and polymorphic microbiomes are two key hallmarks of cancer. The tumor microenvironment (TME) is essential for the development of solid tumors, and the function of tumor-associated macrophages (TAMs) in the TME is closely linked to tumor prognosis. Therefore, research on TAMs could improve the progression and control of certain tumor patients. Additionally, the intestinal flora plays a crucial role in metabolizing substances and maintaining a symbiotic relationship with the host through a complex network of interactions. Recent experimental and clinical studies have suggested a potential link between gut microbiome and TME, particularly in regulating TAMs. Understanding this association could improve the efficacy of tumor immunotherapy. This review highlights the regulatory role of intestinal flora on TAMs, with a focus on gut microbiota and their metabolites. The implications of this association for tumor diagnosis and treatment are also discussed, providing a promising avenue for future clinical treatment strategies.
Assessment of Changes in Cancer Treatment During the First Year of the COVID-19 Pandemic in the US
Authors: Leticia M. Nogueira, Elizabeth J. Schafer, Qinjin Fan, Nikita Sandeep Wagle, Jingxuan Zhao, Kewei Sylvia Shi, Xuesong Han, Ahmedin Jemal, K. Robin Yabroff
Journal: JAMA Oncology (2023)

The COVID-19 pandemic led to disruptions in access to health care, including cancer care. The extent of changes in receipt of cancer treatment is unclear.
Tiered Physician Network Plans and Patient Choices of Specialist Physicians
Authors: Elena Prager, Vilsa E. Curto, Alexa Magyari, Marema Gaye, Anna D. Sinaiko
Journal: JAMA Network Open (2023)

Importance Tiered physician network (TPN) health plans sort physicians into tiers based on their cost and quality, and patients pay lower copays for visits with physicians in the lower-cost and better-quality tiers. When the plans are first introduced, they lead patients to seek care from higher-value physicians. Objectives To examine whether TPNs are associated with patient choice of physician when the plans have been in place for 8 to 12 years and whether there are inequities in patient out-of-pocket costs associated with inequities in access to physicians in lower-copay tiers. Design, Setting, and Participants This cross-sectional study comprising 46 645 physicians and 585 399 patients in TPNs, including 54 683 patients who had a new patient visit with a physician in a TPN, used health insurance claims data from a large employer purchaser from July 1, 2014, to June 30, 2019. Statistical analysis was performed from November 2020 to August 2023. Exposure Evaluation and management visit with a physician in a TPN. Main Outcomes and Measures Main outcomes were new patient market share per physician–carrier–zip code–year, distance from centroid of patient zip code to centroid of zip code of nearest low- or medium-copay physician, and mean TPN physician office visit copay per patient. A regression discontinuity design was used to estimate the association of a physician’s tier ranking, and a difference-in-differences analysis was used to estimate the association of copayment differences across tiers with market share among new patients. Equity in access was measured by comparing travel distance to the nearest physician in a low-copay or medium-copay tier and mean copayments across patient incomes. Results The main analysis sample included 46 645 physician–carrier–zip code–year observations, 9506 (20.4%) of which were in the low-copay tier, 31 798 (68.2%) in the medium-copay tier, and 5341 (11.5%) in the high-copay tier. The 54 683 new patients in the sample had a mean (SD) age of 46.4 (16.7) years and included 33 542 women (61.3%). There was no association of having a worse tier ranking (0.045 percentage points [95% CI, −0.058 to 0.148 percentage points]) or of copayment differences between tiers (0.001 percentage points [95% CI, −0.002 to 0.004 percentage points]) with physician market share among new patients. The patients with the lowest income paid slightly lower mean (SD) copayments for office visits to a TPN physician than the patients with high income ($48.08 [$16.42] vs $51.59 [$16.79], a 6.8% difference). Conclusions and Relevance In this cross-sectional study of TPN health plans, there was no association between physician tier ranking and physician market share among any group of patients. These findings suggest there are limitations in TPNs’ steering of patients toward high-value physicians. These plans were not associated with exacerbated health inequity in this setting.
Implications of High Tumor Burden on Chimeric Antigen Receptor T-Cell Immunotherapy
Authors: Marco Ventin, Giulia Cattaneo, Luke Maggs, Shahrzad Arya, Xinhui Wang, Cristina R. Ferrone
Journal: JAMA Oncology (2023)

Chimeric antigen receptor (CAR) T-cell therapy has redefined the therapeutic landscape of several hematologic malignant tumors. Despite its clinical efficacy, many patients with cancer experience nonresponse to CAR T-cell treatment, disease relapse within months, or severe adverse events. Furthermore, CAR T-cell therapy has demonstrated minimal to no clinical efficacy in the treatment of solid tumors in clinical trials.
Bacterial Decolonization for Prevention of Radiation Dermatitis—Fragility Index Analysis
Authors: Shubhangi Shah, Ronald Chow, Charles B. Simone
Journal: JAMA Oncology (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Oncology HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Oncology journal
Gut microbiota and child behavior in early puberty: does child sex play a role?
Authors: Yangwenshan Ou, Eline Rots, Clara Belzer, Hauke Smidt, Carolina de Weerth
Journal: Gut Microbes (2023)

A growing number of studies have indicated relations between the gut microbiota and mental health. However, to date, there is a scarcity of microbiota studies in community samples in early puberty. The current preregistered study (https://osf.io/wu2vt) investigated gut microbiota composition in relation to sex in low-risk children and explored behavioral associations with gut microbiota composition and metabolites in the same samples, together with the potential role of sex. Fecal microbiota composition was analyzed in 12-year-old children (N = 137) by 16S rRNA gene sequencing and quantitative PCR. Modest sex differences were observed in beta diversity. Generalized linear models showed consistent behavioral relations to both relative and absolute abundances of individual taxa, including positive associations between Parasutterella and mother-reported internalizing behavior, and negative associations between Odoribacter and mother-reported externalizing behavior. Additionally, Prevotella 9 was positively related to mother-reported externalizing behavior, confirming earlier findings on the same cohort at 5 years of age. Sex-related differences were found in behavioral relations to Ruminiclostridium 5, Alistipes, Streptococcus, Ruminiclostridium 9, Ruminococcaceae UCG-5, and Dialister, for relative abundances, as well as to Family XIII AD3011 group and an unidentified bacterium within the Tenericutes, for absolute abundances. Limited behavioral relations were observed regarding alpha diversity and fecal metabolites. Our findings describe links between the gut microbiota and child behavior, together with differences between child sexes in these relations, in low-risk early pubertal children. Importantly, this study confirmed earlier findings in this cohort of positive relations between Prevotella 9 and externalizing behavior at age 10 years. Results also show the merit of including absolute abundances in microbiota studies.
Practice Patterns for Organ Preservation in US Patients With Rectal Cancer, 2006-2020
Authors: Anthony Loria, Mohamedtaki A. Tejani, Larissa K. Temple, Carla F. Justiniano, Alexa D. Melucci, Adan Z. Becerra, John R. T. Monson, Christopher T. Aquina, Fergal J. Fleming
Journal: JAMA Oncology (2023)

In March 2023, the National Comprehensive Cancer Network endorsed watch and wait for those with complete clinical response to total neoadjuvant therapy. Neoadjuvant therapy is highly efficacious, so this recommendation may have broad implications, but the current trends in organ preservation in the US are unknown.
Anticoagulation in Patients With Atrial Fibrillation Who Are Frail—Toward Better Care
Authors: Bernadette Corica, Giulio Francesco Romiti, Marco Proietti
Journal: JAMA Network Open (2023)

Kueiyu Joshua Lin, MD, ScD, MPH; Daniel E. Singer, MD; Darae Ko, MD, MS; Robert Glynn, ScD, PhD; Mehdi Najafzadeh, PhD; Su Been Lee, BA; Lily Gui Bessette, MS; Alexander Cervone, BA; Elyse DiCesare, BA; Dae Hyun Kim, MD, MPH, ScD
Hepatitis C in Black Individuals in the US
Authors: Oluwaseun Falade-Nwulia, Sharon M. Kelly, Sasraku Amanor-Boadu, Benedicta Nneoma Nnodum, Joseph K. Lim, Mark Sulkowski
Journal: JAMA (2023)

Importance In the US, the prevalence of hepatitis C virus (HCV) is 1.8% among people who are Black and 0.8% among people who are not Black. Mortality rates due to HCV are 5.01/100 000 among people who are Black and 2.98/100 000 among people who are White. Observations While people of all races and ethnicities experienced increased rates of incident HCV between 2015 and 2021, Black individuals experienced the largest percentage increase of 0.3 to 1.4/100 000 (367%) compared with 1.8 to 2.7/100 000 among American Indian/Alaska Native (50%), 0.3 to 0.9/100 000 among Hispanic (200%), and 0.9 to 1.6/100 000 among White (78%) populations. Among 47 687 persons diagnosed with HCV in 2019-2020, including 37 877 (79%) covered by Medicaid (7666 Black and 24 374 White individuals), 23.5% of Black people and 23.7% of White people with Medicaid insurance initiated HCV treatment. Strategies to increase HCV screening include electronic health record prompts for universal HCV screening, which increased screening tests from 2052/month to 4169/month in an outpatient setting. Awareness of HCV status can be increased through point-of-care testing in community-based settings, which was associated with increased likelihood of receiving HCV test results compared with referral for testing off-site (69% on-site vs 19% off-site, P &amp;amp;lt; .001). Access to HCV care can be facilitated by patient navigation, in which an individual is assigned to work with a patient to help them access care and treatments; this was associated with greater likelihood of HCV care access (odds ratio, 3.7 [95% CI, 2.9-4.8]) and treatment initiation within 6 months (odds ratio, 3.2 [95% CI, 2.3-4.2]) in a public health system providing health care to individuals regardless of their insurance status or ability to pay compared with usual care. Eliminating Medicaid’s HCV treatment restrictions, including removal of a requirement for advanced fibrosis or a specialist prescriber, was associated with increased treatment rates from 2.4 persons per month to 72.3 persons per month in a retrospective study of 10 336 adults with HCV with no significant difference by race (526/1388 [37.8%] for Black vs 2706/8277 [32.6%] for White patients; adjusted odds ratio, 1.02 [95% CI, 0.8-1.3]). Conclusions and Relevance In the US, the prevalence of HCV is higher in people who are Black than in people who are not Black. Point-of-care HCV tests, patient navigation, electronic health record prompts, and unrestricted access to HCV treatment in community-based settings have potential to increase diagnosis and treatment of HCV and improve outcomes in people who are Black.
Black Race and Hepatitis C—a New Focus for <i>JAMA</i> Narrative Reviews
Authors: Mary M. McDermott, Kirsten Bibbins-Domingo
Journal: JAMA (2023)

Oluwaseun Falade-Nwulia, MBBS, MPH; Sharon M. Kelly, PhD; Sasraku Amanor-Boadu, MD, MPH; Benedicta Nneoma Nnodum, MD, MHS; Joseph K. Lim, MD; Mark Sulkowski, MD
General health warnings about ultra-processed foods are not enough
Authors: Richard M Hoffman
Journal: BMJ (2023)

Touvier and colleagues highlight the importance of informing consumers about the health risks of consuming ultra-processed foods (UPFs). 1 But relying on one-size-fits-all public policies to achieve this is unlikely to be enough.Information based health campaigns that make high cognitive demands can discriminate against some sectors of society. 2 And advice to replace UPFs with healthy home cooking has little impact on those with poor cooking skills or those leading stressful lives who impulsively snack (a major dietary source of UPFs). 3 For many, the precariousness of cooking cannot compete with the convenience and guaranteed taste of ready-to-eat UPFs.UPFs are a main daily pleasure for many of the electorate, so it's not surprising that governments are wary of legislating against them.Many UPFs are tantamount to a 21st century "soma": comforting, hedonistic, and sometimes addictive.
Outcomes in Patients With Postchemotherapy Residual Nonretroperitoneal Disease in Nonseminomatous Germ Cell Tumors
Authors: Jennifer King, Ryan Ashkar, Kenneth Kesler, Sandra K. Althouse, Nasser H. Hanna, Lawrence H. Einhorn, Nabil Adra
Journal: JAMA Oncology (2023)

This case-control study assesses the association between teratoma in the primary tumor or postchemotherapy resections and survival outcomes.